Afraid of Infection, Medical Students in Egypt Want to Postpone Exams

CAIRO—Many medical students and physicians in Egypt are urging the Ministry of Higher Education and Scientific Research to reconsider its decision to go ahead with final examinations for the students in July. The students say the exams will put them, patients and others at risk of being infected with the novel coronavirus and the disease it causes, Covid-19.

Students in the fourth, fifth and sixth year of their training have raised concerns about both written exams and clinical exams, which involve contact or dialogue with patients. They want to postpone or cancel the exams, or replace them with alternative ways of assessing what they have learned, such as research papers or other tasks. (See a related article, “Next Steps for New Online Courses: Measure Learning, Prevent Cheating.”)

The ministry and university administrations have not yet issued responses to the students’ demands and did not immediately respond to requests from Al-Fanar Media for comment.

“There are no specific, clear safety measures. We risk ourselves to sit for tests that can easily be done online or postponed,” said Abdul-Rahman Sameer, a fourth-year medical student at Assiut University. “We will have to attend the exams and will be vulnerable to get infected while on public transportation or in packed examination halls.”

Covid-19 in University Hospitals

Reem Izzat, a sixth-year medical student at Beni Suef University, is also afraid of taking exams. “I am afraid of getting the infection and passing it to my family, especially my parents, for they are both elderly,” she said.

Izzat believes that taking clinical exams at university hospitals, which are often filled with Covid-19 patients and where the staff often don’t have adequate personal protection equipment, is dangerous. “We can avoid such risk by postponing the exams until normal study is resumed,” she said.

Sameer and Izzat are representative of thousands of medical students in Egypt’s 29 medical schools, of which 24 are public and five are private. Many students are  afraid to take exams and complete training at a time when the number of Covid-19 infections is surging. The total number of cases in Egypt has approached 40,000, and more than 1,300 people have died of the disease, according to the Ministry of Health’s data.

The Ministry of Higher Education has required universities to take precautionary measures during exams, such as mandatory face masks, checking students’ temperatures before allowing them to enter, and providing specialized infection control committees. However, students do not think those measures are adequate.

“Most dormitories have been turned into quarantine places for infected cases,” said Ali Ammar, a fourth-year medical student at Assiut University. “This will result in the difficulty of providing accommodations for expatriate students, students from other governorates and remote areas during the exam period.”

In the Wake of a Crisis

The students’ demands come in the aftermath of a crisis between the Egyptian Medical Syndicate, a national organization representing physicians, and the Ministry of Health following the death of a doctor from Covid-19. The physicians’ union accuses the government of failing to provide the doctors with appropriate medical care and of failing to provide health facilities with the necessary medical supplies to prevent personnel from contracting the virus.

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The syndicate warned of a potential collapse of the country’s health system. Over the past years, Egyptian hospitals have suffered from the emigration of doctors, while staff members working on the front lines say they lack adequate medical supplies, including protective equipment. (See a related article, “Egypt’s Doctors are Fleeing, Leaving Behind a Physician Shortage.”)

“The Ministry of Health must fulfill its duty to protect medical personnel, because the situation threatens to cause a crisis,” said Ehab al-Taher, secretary-general of the syndicate. “We might not find doctors at the hospitals.”

Both the Egyptian Medical Syndicate and the Cairo Medical Syndicate have sent letters to government officials, including the Presidency of the Council of Ministers, the House of Representatives and the Ministry of Higher Education, explaining the seriousness of the risks involved in students taking exams.

Holding the exams for students in the final years of Egypt’s six-year medical training system, particularly clinical exams in their traditional form, could turn into a “hotbed of epidemic” for the students, their families and the public, and could pose “a major challenge to the state’s health and economic system in current time,” the syndicates’ letters warn.

Urging the Ministry to Reconsider

Medical students in Egypt’s universities also issued a unified statement asking the Minister of Higher Education to reconsider the decision to hold the exams. The students proposed several alternatives, such as having students write scientific papers in subjects where that is feasible, assessing mastery of theoretical subjects using online tests, and postponing the practical exams for fifth- and sixth-year students that must be taken in person at the teaching hospitals until end of the coronavirus crisis.

The practical exams cannot be taken now, since most university hospitals are being used to quarantine Covid-19 patients.

On the other hand, fourth-year students suggested distributing two subjects—ophthalmology and ear, nose and throat— to the two remaining academic years of study. They suggested taking the theoretical exams only, and postponing the clinical part but keeping it before the start of the new academic year. Contact with the eyes, ears, noses and throats of patients would be especially likely to spread infections.

“I hope our demands will be heard and fulfilled to ensure our safety and the safety of those around us,” said Sameer.